Some governments are making the AIDS crisis worse

AIDS in Canada today would be unrecognizable to the thousands of Canadians who contracted the illness between 1981, when it was discovered, and 1996, when antiretroviral drugs first came into use.

In 1981, a diagnosis of AIDS was a death sentence. But before he died (and he was usually a man) a patient often suffered rejection by friends, society at large, even family. Many of AIDS's first victims died alone, young men whose shrunken frames and hacking coughs made them too frightening to be with.

But today, a Canadian newly infected with HIV-AIDS can, with the help of antiretroviral therapy, expect to live another 13 years. Because of that, we are in danger of turning AIDS into just one illness among others. But AIDS remains in a class by itself, the "leading infectious disease challenge in global health," according to the World Health Organization.

As 22,000 scientists, medical workers, activists and journalists from 175 countries gathered in Mexico City for this week's 17th International AIDS Conference, the head of the International AIDS Society, Dr. Pedro Cahn, warned that the world is "not on course to meet universal access targets."

About 33 million people are infected with AIDS worldwide, but still far too few of them have access to antiretroviral therapy. The number of infections is swelling at a rate of 2.5 million a year. Globally, more than 25 million people are reported to have died of AIDS since 1981, mainly in the developing world.

Even in Canada, where antiretroviral therapy is freely available, AIDS continues its destructive path. About 58,000 people in Canada live with AIDS; by 2005 more than 13,000 Canadians had died of AIDS.

How many Canadians know this, especially within the groups at highest risk of infection, homosexual men particularly? Few, it's safe to say, with awareness campaigns gone the way of padded shoulders and big hair.

This is equally true in the U.S., where the Bush administration's emphasis on abstinence has pushed aside other prevention programs. But the need to stem HIV infection was brought home this week when the U.S. Centres for Disease Control and Prevention, using a new, more accurate measure, found the U.S. infection rate was 40 per cent higher than previously estimated, bringing to 1.25 million the number of Americans with HIV.

These numbers pale next to the devastation AIDS continues to wreak in the developing world, where 90 per cent of the victims of HIV-AIDS live.

Without a vaccine, prevention and treatment are the only two cards available to play at this point. In China, the United Nations has warned, there could be 10 million people with HIV within two years unless the country acts urgently to start campaigns both to educate the public and fight the epidemic. As in the West 20 years ago, AIDS is viewed by many in China as a shameful secret.

But China is hardly alone. Governments around the world are making this health crisis worse through their refusal to identify needs and fund them appropriately, according to amfAR, a leading AIDS support body. This week in Mexico, the group reported on the explosion of infection among men who have sex with men, known as MSM. The report asks, rhetorically, "MSM, HIV, and the Road to Universal Access - How Far Have We Come?"

Not far at all. AmfAR reported that globally, men who have sex with men are 19 times more likely to be infected with HIV than the general population. In Latin America, that likelihood reaches 33 times. Even in sub-Saharan Africa, where HIV epidemics have spread through the general population, homosexuals are nearly four times more likely than the general population to be infected with HIV, amfAR said.

Homosexual men account for more than 25 per cent of HIV-infections in Latin America, but programs directed to them receive less than one per cent of HIV-AIDS funding in the region, amfAR reported. Elsewhere in the world, amfAR found that the criminalization of male-with-male sexual activity is the "major driver" of the epidemic among homosexual men. Around the world, 86 countries - from Egypt to Jamaica - criminalize homosexual activity.

Hounding vulnerable populations on the one hand, ignoring them on the other - both in the developing world and the wealthy West, we're still a long way from acknowledging how seriously we need to take this deadly epidemic.